title: Vascular invasion in hepatocellular carcinoma: is there a correlation with MRI?
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is one of the commonest malignancies worldwide. Prognosis is predicted by size at diagnosis, vascular invasion and tumour proliferation markers. This study investigates if MRI features of histologically proven HCCs correlate with vascular invasion.
  
  
  METHODS
  Between 2006 and 2008, 18 consecutive patients, with a total of 27 HCCs, had comprehensive MRI studies performed at our institution within a median of 36 days of histology sampling. Each lesion was evaluated independently on MRI by 3 radiologists (blinded to both the radiology and histopathology reports) using a 5-point confidence scale for 23 specific imaging features. The mean of the rating scores across readers was calculated to determine interobserver consistency. The most consistent features were then used to examine the value of features in predicting vascular invasion, using a χ(2 )test for trend, having eliminated those features without sufficient variability.
  
  
  RESULTS
  22 of the 23 imaging features showed sufficient variability across lesions. None of these significantly correlated with the presence of vascular invasion, although a trend was identified with the presence of washout in the portal venous phase on MRI and the median size of lesions, which was greater with vascular invasion.
  
  
  CONCLUSIONS
  This study suggests that no single MRI feature accurately predicts the presence of vascular invasion in HCCs, although a trend was seen with the presence of washout in the portal venous phase post gadolinium. Larger prospective studies are required to investigate this further.
authors.affiliation: Department of Radiology, Guys and St Thomas' Hospital, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Griffin
authors.forename: H
authors.initials: H
authors.lastname: Addley
authors.forename: E
authors.initials: E
authors.lastname: Sala
authors.forename: A S
authors.initials: AS
authors.lastname: Shaw
authors.forename: L A
authors.initials: LA
authors.lastname: Grant
authors.forename: H
authors.initials: H
authors.lastname: Eldaly
authors.forename: S E
authors.initials: SE
authors.lastname: Davies
authors.forename: T
authors.initials: T
authors.lastname: Prevost
authors.forename: G J
authors.initials: GJ
authors.lastname: Alexander
authors.forename: D J
authors.initials: DJ
authors.lastname: Lomas
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D019043:Vascular Neoplasms / Q000473:pathology*